All about elephantine blisters

What is a bullae?

- a fluid filled blister greater than 5cm in diameter

- fluid = blood, serum, pus

What is Bullous Pemphigoid (BP)?

Bullous pemphigoid is an autoimmune disease, commonly seen in the older age groups, where IgGs are produced against hemidesmosomal proteins in the subepidermal layer. They typically present with tense blisters which are either itchy or painful, commonly sparing the mucous membranes. The prognosis is more benign than its cousin (pemphigus vulgaris) and is usually Nikolsky's negative.

What is Pemphigus vulgaris (PV)?

Pemphigus vulgaris (PV) is an autoimmune disease where autoimmune antibodies IgGs are produced against the desmoglein protein. Targetting the desmosomes in the intraepidermal layer, PV generally affects the younger age groups, involves the mucous, and forms painful flaccid bullae which are Nikolsky's +ve. Prognosis is usually worse than BP.